Hemolysis and its outcome following percutaneous closure of cardiac defects among children and adolescents: a prospective study

Abstract

Background Transcatheter closure of intracardiac defects might be complicated by intravascular hemolysis. We evaluated hemolysis and its outcome after transcatheter closure of these defects. Methods and patients All patients who underwent transcatheter closure of patent ductus arteriosus, ventricular septal defect and atrial septal defect were included in this prospective study. Clinical data were obtained before and after the catheterization. Results One hundred and thirty-eight patients were enrolled; and four (3%) patients developed intravascular hemolysis; while two cases had residual shunt and two other cases had not residual flow. Although residual shunt occurred in ten patients, only 2 of these cases developed hemolysis. Patent ductus arteriosus closure was done for one of these cases and the other one, underwent perimembranous ventricular septal defect closure. Moreover, hemolysis occurred after device closure of patent ductus arteriosus in 2 of the other patients with no residual shunt. In this study the hemolysis was eliminated by conservative management within 2 weeks although residual shunt continued in this time. We observed a decline in lactate dehydrogenase value after catheterization in comparison with precatheterization, which was mainly among ventricular septal defect patients that might be due to mild chronic hemolysis in these patients. Conclusion Incidence of hemolysis after device closure was low, and occurred with and without residual flow and was eliminated by conservative management in 2 weeks, without the need for surgery, although the residual shunt was continued.

The Outcome of Trans-catheter Closure of Patent Ductus Arteriosus: A Single-Center Experience

“…Hemolysis can occur with or without residual shunts following PDA device closure. Amoozgar et al [ 15 ] reported four cases of hemolysis out of total 138 cases following device closure of left to right shunts. Mortality of surgical PDA ligation has been reported to be as high as 2% in one study [ 16 ] while mortality from trans-catheter PDA closure is low.…”

Device Occlusion of Native Pulmonary Blood Flow After Cavopulmonary Anastomosis With Persistent Pleural Effusions

“…In view of the initial residual forward flow through the device, the patient was regularly followed up with echocardiography ( Figure 4 , Video 4 ) and monitored for signs of hemolysis. 2 He had preliminary evidence of hematuria on urinalysis and raised lactate dehydrogenase levels. This was managed conservatively and resolved within 3 weeks.…”

Tratamiento de la Comunicación Interventricular (CIV) congénita con dispositivos de inserción percutánea y perventricular

“…El cierre del defecto del tabique interventricular mediante técnica percutánea, puede generar hemólisis, fundamentalmente debido a un cortocircuito residual o a una exposición mecánica del dispositivo de cierre al flujo sanguíneo que habitualmente no precisa de la retirada ni recambio del dispositivo y, según las series de casos, aparece entre un 0,7 y un 15% de los casos 24 .…”

“…El listado definitivo de desenlaces con los que se ha trabajado en el presente informe se pueden ver en la tabla 6. Anexo Amoozgar et al 2019 24 Desenlaces sin interés para la pregunta de investigación.…”